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Serum levels of tumour necrosis factor alpha and other cytokines do not correlate with weight loss and anorexia in cancer patients

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Abstract

Cancer anorexia-cachexia syndrome (CACS), which is characterized by progressive weight loss (WL) and anorexia (A), is present in 50% of advanced cancer patients and in 80% of terminally ill cancer patients. One of the most controversial aspects of CACS is its oetiopathogenesis; experimental studies have identified certain cytokines [Tumour necrosis factor alpha (TNF-α), interleukin 1 (IL-1), interleukin 6 (IL-6), and gamma interferon (\gg-IFN)] as possible cofactors in the onset of the syndrome. The aim of our study was to investigate the correlation between serum levels of circulating cytokines and severity of CACS. The following series of parameters was indentified in 61 patients with advanced and terminal cancer: stage of disease; Karnofsky performance status (KPS) and clinical symptoms; biohumoral, anthropometric and immunological situation; level of circulating cytokines. All these parameters were evaluated for a possible link with WL/A. Our data do not show any significant correlation between circulating cytokines and WL/A. A direct correlation was identified between WL/A and nausea (P=0.03 andP<0.001, respectively) whereas inverse correlations were observed for both factors as regards arm circumference (P<0.001 for both), wrist circumference (P<0.001 for both), KPS (P<0.001 andP=0.003, respectively) and creatinine (P=0.005 andP=0.03, respectively). Other biochemical factors, such as haemoglobin, haematocrit, glycaemia, prealbumin, sodium and chlorine were also correlated with at least one of the two clinical parameters in question. Unexpected results were seen in the increases in CD20 and CD4 and in the CD4/CD8 ratio. Serum levels of these cytokines do not, therefore, appear to be critical in the onset of CACS. On the contrary, our findings confirmed the clinico-laboratory picture that is characteristic of CACS. If we consider the possibility that CACS is provoked by an aspecific response of the host's defence mechanisms against prolonged neoplastic attack, the increase in CD4 (helper lymphocytes) could be linked to the persistent response.

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Authors and Affiliations

  1. Divisione Oncologia Medica, Ospedale Pierantoni, Via Forlanini, 34, I-47100, Forlì, Italy

    Marco Maltoni M.D., Laura Fabbri Ph.D., Emanuela Flamini Ph.D., Angela Riccobon Ph.D., Stefania Derni M.D. & Dino Amadori M.D.

  2. Unità: Operativa di Biostatistica, Istituto Oncologico Romagnolo, Forlì, Italy

    Oriana Nanni Ph.D. & Emanuela Scarpi Ph.D.

  3. Laboratorio Analisi e Ricerche Cliniche, Ospedale Pierantoni, Forlì, Italy

    Laura Pezzi Ph.D. & Gualtiero Pallotti M.D.

Authors
  1. Marco Maltoni M.D.
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  2. Laura Fabbri Ph.D.
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  3. Oriana Nanni Ph.D.
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  4. Emanuela Scarpi Ph.D.
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  5. Laura Pezzi Ph.D.
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  6. Emanuela Flamini Ph.D.
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  7. Angela Riccobon Ph.D.
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  8. Stefania Derni M.D.
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  9. Gualtiero Pallotti M.D.
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  10. Dino Amadori M.D.
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Maltoni, M., Fabbri, L., Nanni, O. et al. Serum levels of tumour necrosis factor alpha and other cytokines do not correlate with weight loss and anorexia in cancer patients. Support Care Cancer 5, 130–135 (1997). https://doi.org/10.1007/BF01262570

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